Confused and need help

adf4 · March 2013

I have been going to an Integrative Dr....they have helped me w/ my hormones (progesterone, etc)....my cortisol levels(adrenal glands) are still low and she has me taking something new for that. My main frustration is my thyroid...I have more HYPER levels, but have HYPO symptoms. They have done tons of bloodwork, radioactive uptake scan, ultrasound(had a small nodule and nothing to worry about there)..they are classifying me as Euthyroid Sick Syndrome and they have never seen any levels like mine. They seem to be trying to help and not have to send me to an endo (they get a lot of patients that went to endo and got NO help at all). I wanted to share some of my bloodwork with y'all and get other opinions. I've been dieting and exercising for 3 yrs w/ little results. Here's my levels:

T4 Free: .97 (Normal Range .82 - 1.77)
Reverse T3: 40.7 (NR 9.2-24.1)
T4: 15.7 (NR 4.5-12.0)
T3: 356 (NR 71-180)
TBG: 59 (NR 13-39)
Triidothyronine,Free (not sure what this is): 4.2 (NR 2.0-4.4)

Any ideas or help would be VERY much appreciated! They currently have me on a straight T3(cytomel)..which makes no sense to me since my t3 has always been so high. I'm also on glutathione, milk thistle,B12, and Adrenal complex.

ginnylee75 · March 2013

Hi there.

I don't know if this will help or not, I'm sending you a sight that you might want to check out. http://nahypothyroidism.org/thyroid-hormone-transport/#pituitary.

It is a bit heavy but if you really concentrate on it you will understand what it means. At least that is what I had to do. You have an option to print it out and take the page to the doctor that is trying to help you.

Also google Euthyroid Sick Syndrome and see what comes up. StoptheThyroidMadness.com has tons of information that you might find interesting. Your doctor may be willing to read some of that info too. Can't hurt.:drinker:

Good luck,
Ginny :flowerforyou:

adf4 · March 2013

Thanks, Ginny for the website. I did take a look at it and according to it, it looks like the T3 is what I need (and that is what they are giving me). I have googled Euthyroid Sick Syndrome and mostly it talks about people who are in Intesive Care, or who are VERY sick (Aids, liver problems, etc...none of which I have..they tested all of that)..and sometimes I think when they can't correctly diagnose, they'll label you as having this (well, most regular Dr.'s and endo's don't even believe this exists unless you are critically ill in the hospital).

I have read some on the Stop the thyroid madness and according to it, I need the T3 too along w/ a lot of adrenal support. I have been on the straight T3 for about 5 mths with little to no change in my levels. Also, my mom and my aunt both have HYPERthyroidism, but they had all the correct symptoms to go along w/ theirs.

My Dr.'s are totally fine w/ me finding info and bringing it to them(they actually suggested that)..they are very open and I feel that they are trying to help.

Thanks again!

islandmonkey · March 2013

T4 Free: .97 (Normal Range .82 - 1.77)
Reverse T3: 40.7 (NR 9.2-24.1)
T4: 15.7 (NR 4.5-12.0)
T3: 356 (NR 71-180)
TBG: 59 (NR 13-39)
Triidothyronine,Free (not sure what this is): 4.2 (NR 2.0-4.4)

Any ideas or help would be VERY much appreciated! They currently have me on a straight T3(cytomel)..which makes no sense to me since my t3 has always been so high. I'm also on glutathione, milk thistle,B12, and Adrenal complex.

T4 has 4 iodine molecules, T3 has 3, etc. Triiodothyronine = T3.

That's a crazy high Reverse T3 result. Reverse T3 is an issue because it binds to the same receptors as T3, and blocks T3 from doing its job - making you feel hypo. That's why you feel hypo now, because your RT3 is out of control.

That's also why they have you on a high dose of T3-only; they're trying to clear out that RT3 level. A T3-only med helps keep your free T4 levels low, because your body is currently turning that T4 into RT3, when it should be making T3. However, your body is still pumping out lots of T4 hormone, which is the only weird part I see....did they specify from the Uptake scan whether they thought you had Hashimoto's? Have you been tested for anti-TPO antibodies to confirm? They should also check for TSI antibodies (graves disease) but that should have been clear from the uptake scan as well. Is your family history with autoimmune hyperthyroid, i.e. graves?

For whatever reason, your thyroid is pumping out a lot of T4 and turning it in to RT3. The adrenal issues and low cortisol all feed into that system; there's some good info here on that:
http://www.stopthethyroidmadness.com/reverse-t3/

On top of that, there's the whole total vs. free T3/T4. Of the total amounts shown, over 99% (in "normal" patients) is bound to carrier proteins, and is biologically inactive. The remaining <1% is the "free" amount that your body can actually use, and low levels of the free hormones are what make people feel hypo. Your body is doing something different - your protein binding hormones are super high (that's the TBG result), which means that MORE than 99% is getting bound up, further making you feel hypo.

Summary: your body is pumping out tons of T3 and T4, but it's getting all bound up in proteins and isn't available for your body to use. Of that free amount, your body is further sabotaging you by making RT3 instead of T3.

I disagree that your levels are hyper. I think your total T3 and T4 are high, and I'm guessing your TSH is suppressed? But even that free T3 level isn't that high - I would absolutely expect you to be feeling hypo with those levels right now.

I'd strongly encourage you to join this group:
http://community.babycenter.com/groups/a3695/thyroid_issues_concerns

Don't worry, it's not just for pregnant ladies!! It's just an amazing group of VERY thyroid-savvy women who can probably help a bit more. Several women there have successfully dealt with RT3 issues, and with adrenal fatigue. Your situation isn't common, but not unique, and CAN be managed. Sounds like you have some decent thyroid doctors which is an amazing start.

adf4 · March 2013

Thanks for your clarification...my Dr.'s explained it to me, but I didn't write it down, so therefore forgot a majority of what they said.

They did the TPO and it was fine and I do not have graves disease and neither did my mom (not sure about my aunt)...my mom"s has been controled by meds and my aunt had her thryoid destroyed w/ radiation. My uptake scan came back fine. My TSH was within a normal level (that was one set of bloodwork that they forgot to email me, but I did ask them about it and they said it was normal).

I will check out the website/group.

Thanks so much for your input! :flowerforyou: All of this can be so confusing and overwhelming!:grumble:

islandmonkey · March 2013

I'd be very surprised if your aunt had RAI without having graves - that would be a fairly uncommon treatment.

It's just really unusual to have hyperthyroid for no reason. And when it runs in families it's generally autoimmune (graves or hashi's). Is your mom on methimazole/tapazole? Or did it go into remission? I'd encourage her to get retested for graves, and to ensure they are testing her free T3. Often with hyperthyroid they just test TSH and free T4, and people end up with "normal" labs but free T3 levels that are too high and cause issues.

I feel like I'm missing something, so will think on this for a bit. I have the same userID over there so hope to see you posting.

adf4 · March 2013

My aunt probably did have graves. Currently my mom isn't taking anything and is fine and symptom free at the time. She went to an endo, and I'm not sure what they tested on her. I just posted on the other site you suggested..so we'll see.

adf4 · March 2013

I asked my Dr. to email me the other labs.

TSH: 2.030 (normal range is .450-4.500)
TPO Ab: 9 (normal range is 0-34)

Didn't know if this would help anyone to understand things better or not.

Hypothyroidism and Hyperthyroidism

Confused and need help

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